Digital Commons Network^™

Vision Loss Among Delaware Nursing Home Residents, Robert B. Å. Andersson, Mashael Al-Namaeh, William A. Monaco, Hongdao Meng

Aging Studies Faculty Publications

Objectives: To determine the prevalence of vision loss among Delaware nursing home residents for further data collection to expand the existing evidence about the vision loss among nursing home residents on a national level.

Methods: This cross-sectional study involved the statistical analysis of comprehensive eye examination records of 1,856 nursing residents residing in 20 Delaware nursing homes from 2005 to 2011. Descriptive statistical analyses were conducted to identify age-specific prevalence rates of vision loss (moderate-to-severe vision impairment and blindness).

Results: The mean age of nursing home residents was 82.54 years (range: 65–111 years), and 61.70% were over the age of …

Caregiver Well-Being And Burden: Variations By Race/Ethnicity And Care Recipient Nativity Status, Heehyul E. Moon, William E. Haley, Sunshine M. Rote, Jeanelle S. Sears

Aging Studies Faculty Publications

Background and Objectives

Despite growing diversity among the aging population and extensive previous research on racial/ethnic minority caregivers, little research has been conducted on the potentially unique experiences and outcomes of informal caregivers of foreign-born care recipients. Using nationally representative data and the Stress Process Model, the current study examined the differences in caregiver outcomes (care burden, psychological well-being, and self-rated health) by care recipient nativity status (U.S.-born vs. foreign-born) and the extent to which caregiver outcomes vary by care recipient nativity status and caregiver race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, and Others). Research Design and Methods

The current study …

Neurobiological Differences Between Aggression And Agitation In Persons With Dementiaaffiliation, Ladislav Volicer

Aging Studies Faculty Publications

Background: Controversy exists about definition of agitation and especially about inclusion of aggression as a part of agitation in people with dementia.

Methods: Papers describing neurobiological indices related to behavioral symptoms of dementia were reviewed. Papers comparing indices in persons exhibiting aggression and persons exhibiting agitation were selected for this review.

Results: The survey found seven papers which compared neuroanatomical indices and three papers which compared neurochemical indices. The neuroanatomical indices differentiating agitation and aggression included changes in brain perfusion, sizes of brain areas, distribution of neurofibrillary tangles, and white matter changes. The neurochemical indices differentiating agitation and aggression included …

Correlates Of Life Satisfaction Among Middle-Aged And Older Black Adults, Shyuan Ching Tan, Alyssa Gamaldo, Angie L. Sardina, Ross Andel

Aging Studies Faculty Publications

This study explored satisfaction across life domains (e.g., family, daily life, health, finances, city of residence) and correlates of satisfaction across domains. Black adults (n=93, age range=55-80) completed the domains of life satisfaction scale and measures of sociodemographic factors, personality, and mental/physical health. Participants’ satisfaction was highest for home condition, but lowest for health. Univariate analyses of variance demonstrated better life satisfaction in the oldest-old (80+) than the youngest-old (55-64; p<.05), particularly in the domains of daily life/leisure, current financial situation, and total household income. Linear regression models suggested that higher satisfaction was associated with less education, less financial strain, lower depressive symptoms, and better self-rated physical health, although the pattern of results varied by domain. Satisfaction may increase with advancing old age, at least in some life domains. It can also vary across life domains and unique factors likely relate to satisfaction in each life domain.

Psychological And Social Factors Associated With Sleep Health Across Adulthood, Soomi Lee, Orfeu M. Buxton

Aging Studies Faculty Publications

Sleep is associated with all-cause mortality, cardiovascular disease, cognitive impairment, as well as daily social interactions and productivity. Studies often have focused on sleep duration only, lacking the ability to comprehensively understand the importance of age-related changes in varied facets of sleep health. Moreover, psychological and social factors that may be associated with sleep health in adulthood are still poorly understood. This symposium showcases contemporary endeavors towards understanding how diverse indicators of sleep health relate to psychological and social factors across adulthood. Paper 1 uses perceived job discrimination as a social stressor to test associations between perceived job discrimination and …

The Examination Of Determinants And Barriers To End-Of-Life Decision Making And Planning, Brittany E. Gaines, Debra J. Dobbs

Aging Studies Faculty Publications

As individuals are living longer, in many cases with chronic diseases, there is an increased focus on end-of-life (EOL) planning and decision making. This includes a broad spectrum of choices including advance care planning (ACP) and turning to palliative care or hospice care. Although there has been an increase in palliative and hospice care enrollment and ACP engagement over the past decade, participation remains low for certain subgroups of the population. The purpose of this symposium is to offer insight into reasons for these varying rates of engagement by exploring determinants and barriers to EOL decision making and planning and …

Personality And Self-Reported And Actigraphy-Measured Sleep Health In Adulthood, Nasreen A. Sadeq, Soomi Lee, Alyssa Gamaldo, David M. Almeida

Aging Studies Faculty Publications

Personality may be associated with sleep health, however, the majority of existing studies rely on self-reported measures of sleep (often focusing on sleep duration). The purpose of this study is to examine the associations between Big Five personality traits and self-reported and actigraphy measured sleep. This study included 3928 participants and a subsample of 441 participants from the Midlife in the United States study. Linear regressions were used to analyze the relationships between personality traits and sleep. Neuroticism was associated with more frequent actigraphy-measured waking after sleep onset, and several self-reported measures of sleep quality, including shorter sleep duration, longer …

The Use Of Mobility Devices And Personal Assistance: A Joint Modeling Approach, Hongdao Meng, Lindsay J. Peterson, Lijuan Feng, Debra Dobbs, Kathryn Hyer

Aging Studies Faculty Publications

Objective: To examine whether mobility device use substitutes for personal assistance among U.S. older adults.

Method: Using the National Health and Aging Trends Study, we identified 3,211 community-living older adults (aged 65 and older) who reported mobility difficulties at baseline. We used recursive bivariate probit models to simultaneously estimate the effect of covariates on the likelihood of using (a) mobility devices and (b) personal assistance to accommodate mobility difficulty. Independent variables included age, gender, race, physical/mental health status, cognition, and comorbidities.

Results: Predictors of the use of personal assistance and mobility devices exhibit important similarities and differences. Device use reduced …

Effects Of The Namaste Care Family Programme On Quality Of Life Of Nursing Home Residents With Advanced Dementia And On Family Caregiving Experiences: Study Protocol Of A Cluster-Randomised Controlled Trial, Hanneke J. A. Smaling, Karlijin J. Joling, Peter M. De Ven, Judith E. Bosmans, Joyce Simard, Ladislav Volicer, Wilco P. Achterberg, Anneke L. Francke, Jenny T. Van Der Steen

Aging Studies Faculty Publications

Introduction: Quality of life of people with advanced dementia living in nursing homes is often suboptimal. Family caregivers can feel frustrated with limited contact with their relatives, which results in visits that are perceived as stressful and not very meaningful. Few psychosocial interventions are specifically developed for people with advanced dementia, and actively involve family caregivers or volunteers. Also, interventions usually stop when it becomes difficult for people to participate. The Namaste Care Family programme aims to increase the quality of life of people with advanced dementia, and improve family caregiving experiences through connecting to people and making them comfortable. …

Occupational Stress And Risk For Parkinson's Disease: A Nationwide Cohort Study, Johanna Sieurin, Ross Andel, Annika Tillander, Elise G. Valdes, Nancy L. Pederson, Karin Wirdefeldt

Aging Studies Faculty Publications

Background: Stress has been suggested as a contributing factor in the etiology of Parkinson's Disease (PD), but epidemiological evidence is sparse.

Objective: The objective of this study was to explore the association between occupational stress according to the job demands‐control model and the risk for PD.

Methods: We conducted a population‐based cohort study with 2,544,748 Swedes born 1920 to 1950 who had an occupation reported in the population and housing censuses in 1980 or, if missing, in 1970. Job demands and control were measured using a job‐exposure matrix. Incident PD cases were identified using Swedish national health registers from 1987 …

Comparison Of The Flexible Parametric Survival Model And Cox Model In Estimating Markov Transition Probabilities Using Real-World Data, Xudong Du, Mier Li, Ping Zhu, Ju Wang, Lisha Hou, Jijie Li, Hongdao Meng, Muke Zhou, Cairong Zhou

Aging Studies Faculty Publications

Background and Objective: Markov micro-simulation models are being increasingly used in health economic evaluations. An important feature of the Markov micro-simulation model is its ability to consider transition probabilities of heterogeneous subgroups with different risk profiles. A survival analysis is generally performed to accurately estimate the transition probabilities associated with the risk profiles. This study aimed to apply a flexible parametric survival model (FPSM) to estimate individual transition probabilities.

Materials and Methods: The data were obtained from a cohort study investigating ischemic stroke outcomes in Western China. In total, 585 subjects were included in the analysis. To explore the goodness …

Factors Associated With Willingness To Enter Long-Term Care Facilities Among Older Adults In Chengdu, China, Ziyue Huang, Qingyue Liu, Hongdao Meng, Dangping Liu, Debra Dobbs, Kathryn Hyer, Kyaien O. Conner

Aging Studies Faculty Publications

Objective: To describe Chinese older adults’ willingness to enter long-term care facilities and to examine individual factors associated with the willingness of using this growing model of long-term care in China.

Methods: A cross-sectional study involving a random sample of 670 adults aged 60+ in the Hezuo community in Chengdu, China in 2016. Respondents were interviewed by trained staff on socio-demographics, health status, quality of life, social support, and willingness to enter long-term care facilities.

Results: Only 11.9% of the respondents were willing to enter long-term care facilities for meeting their medical and social service needs. Multivariable logistic regression analysis …

Changes In Hypertension-Related Knowledge And Behavior And Their Associations With Socioeconomic Status Among Recently Urbanized Residents In China: 2013–2016, Wenjie Zhang, Hongdao Meng, Shujuan Yang, Honglin Luo, Danping Liu

Aging Studies Faculty Publications

The rapid urbanization in China has brought with it some health benefits, but it also brought about a negative influence on the lifestyle of residents. We conducted this study to assess the change in hypertension-related knowledge and behavior from 2013 to 2016 among recently urbanized residents and determine their association with socioeconomic status (SES). This research used data from two cross-sectional studies conducted in Hezuo community in Chengdu, Sichuan province of China. A total of 2268 and 2601 individuals, respectively, participated and completed standard questionnaires. According to the results, the median (IQR) scores of health knowledge was 1 (0,3) and …

The Association Between Assisted Living Direct Care Worker End-Of-Life Training And Hospice Use Patterns, Debra Dobbs, Sharon Kaufman, Hongdao Meng

Aging Studies Faculty Publications

As resident acuity levels increase for those who reside in assisted living (AL), states allow for hospice care provision in AL. End-of-life care training for staff can potentially increase the awareness of benefits of hospice care for AL residents. This study examined the association between AL staff trained in end-of-life care and hospice utilization in a sample of ALs (n = 45) in Florida. The sample included ALs (n = 21) with a low percentage (≤59%) and ALs (n = 24) with a high percentage (≥60%) of staff trained in end-of-life care as reported by AL directors. …

Sleep Disturbance In Men Receiving Androgen Deprivation Therapy For Prostate Cancer: The Role Of Hot Flashes And Nocturia, Brian D. Gonzalez, Brent J. Small, Mallory G. Cases, Noelle L. Williams, Mayer N. Fishman, Paul B. Jacobsen, Heather S. L. Jim

Aging Studies Faculty Publications

Background: Patients with prostate cancer receiving androgen deprivation therapy (ADT) are at risk of sleep disturbance; however, to the authors' knowledge, the mechanisms by which ADT may affect sleep are not well understood. The current study compared objective and subjective sleep disturbance in ADT recipients and controls and examined whether sleep disturbance in ADT recipients is attributable to the influence of ADT on hot flashes and nocturia.

Methods: Patients with prostate cancer were assessed before or within 1 month after the initiation of ADT as well as 6 months and 12 months later (78 patients). Patients with prostate cancer were …

Men Lacking A Caregiver Have Greater Risk Of Long‐Term Nursing Home Placement After Stroke, Justin Blackburn, Karen C. Albright, William E. Haley, Virginia J. Howard, David L. Roth, Monika M. Safford, Meredith L. Kilgore

Aging Studies Faculty Publications

Background/Objectives: Social support can prevent or delay long‐term nursing home placement (NHP ). The purpose of our study was to understand how the availability of a caregiver can affect NHP after ischemic stroke and how this affects different subgroups differently.

Design: Nested cohort study.

Setting: Nationally based RE asons for Geographic and Racial Differences in Stroke (REGARDS ) study.

Participants: Stroke survivors aged 65 to 100 (256 men, 304 women).

Measurements: Data were from Medicare claims from January 2003 to December 2013 and REGARDS baseline interviews conducted from January 2003 to October 2007. Caregiver support was measured by asking, “If …

Culture Change In Nursing Homes: What Is The Role Of Nursing Home Resources?, Latarsha Chisholm, Ning J. Zhang, Kathryn Hyer, Rohit Pradhan, Lynn Unruh, Feng-Chang Lin

Aging Studies Faculty Publications

Quality of care has been a long-standing issue in US nursing homes. The culture change movement attempts to transition nursing homes from health care institutions to person-centered homes. While the adoption of culture change has been spreading across nursing homes, barriers to adoption persist. Nursing homes that disproportionately serve minority residents may have additional challenges implementing culture change compared with other facilities due to limited financial and staffing resources. The objective of this study was to examine how nursing home characteristics are associated with culture change adoption in Central Florida nursing homes. This cross-sectional study included 81 directors of nursing …

The Role Of Assisted Living Capacity On Nursing Home Financial Performance, Justin Lord, Ganisher Davlyatov, Kali S. Thomas, Kathryn Hyer, Robert Weech-Maldonado

Aging Studies Faculty Publications

The rapid growth of the assisted living industry has coincided with decreased levels of nursing home occupancy and financial performance. The purpose of this article is to examine the relationships among assisted living capacity, nursing home occupancy, and nursing home financial performance. In addition, we explore whether the relationship between assisted living capacity and nursing home financial performance is mediated by nursing home occupancy. This research utilized publicly available secondary data, for the state of Florida from 2003 through 2015. General descriptive statistics were used to assess the relationships among financial performance, assisted living capacity, and occupancy. To explore the …

Influence Of Dynamic Neuromuscular Stabilization Approach On Maximum Kayak Paddling Force, Pavel Davidek, Ross Andel, Alena Kobesova

Aging Studies Faculty Publications

The purpose of this study was to examine the effect of Dynamic Neuromuscular Stabilization (DNS) exercise on maximum paddling force (PF) and self-reported pain perception in the shoulder girdle area in flatwater kayakers. Twenty male flatwater kayakers from a local club (age = 21.9 ± 2.4 years, body height = 185.1 ± 7.9 cm, body mass = 83.9 ± 9.1 kg) were randomly assigned to the intervention or control groups. During the 6-week study, subjects from both groups performed standard off-season training. Additionally, the intervention group engaged in a DNS-based core stabilization exercise program (quadruped exercise, side sitting exercise, sitting …

Anxiety And Depression In Spanish-Speaking Latina Cancer Patients Prior To Starting Chemotherapy, Morgan S. Lee, Dinorah Martinez Tyson, Brian D. Gonzalez, Brent J. Small, Suzanne C. Lechner, Michael H. Antoni, Andrea Vinard, Madeline Krause, Cathy Meade, Paul B. Jacobsen

Aging Studies Faculty Publications

Objective: Anxiety and depression can substantially impact the life of a cancer patient, but literature on emotional distress in the Hispanic cancer population is sparse. Additionally, the influence of psychosocial variables including age, acculturation, and spiritual well‐being on emotional distress in this population remains unclear. The purpose of the present report was to assess the prevalence of anxiety and depression in Spanish‐speaking Latina cancer patients preparing to begin chemotherapy and to explore the predictors and correlates of these outcomes.

Methods: Participants were 198 Spanish‐speaking Latina cancer patients who completed measures of anxiety, depression, acculturation, and spiritual well‐being prior to starting …

The Influence Of Professional Identity, Job Satisfaction, And Work Engagement On Turnover Intention Among Township Health Inspectors In China, Wenjie Zhang, Hongdao Meng, Shujuan Yang, Danping Liu

Aging Studies Faculty Publications

Health inspectors are part of the public health workforce in China, and its shortage has been identified as an urgent priority that should be addressed. Turnover is one of the main contributors to the shortage problem. This research assessed the influence of professional identity, job satisfaction and work engagement on turnover intention of township health inspectors and explored the intermediary effect of job satisfaction and work engagement between professional identity and turnover intention among township health inspectors in China. Data were collected from 2426 township health inspectors in Sichuan Province, China. We used structural equation modeling (SEM) to test the …

The Bdnf Val66met Polymorphism Moderates The Effect Of Cognitive Reserve On 36-Month Cognitive Change In Healthy Older Adults, David D. Ward, Ross Andel, Nichole L. Saunders, Megan E. Thow, Shannon Z. Klekociuk, Aidan D. Bindoff, James C. Vickers

Aging Studies Faculty Publications

Introduction: Cognitive reserve (CR) and BDNF Val66Met are independently associated with the rate of cognitive decline in preclinical Alzheimer's disease. This study was designed to investigate the interactive effects of these variables on 36-month cognitive change in cognitively intact older adults.

Methods: Data for this investigation were obtained from 445 community-residing participants of the Tasmanian Healthy Brain Project, who underwent genetic screening and annual assessment of neuropsychological, health, and psychosocial function.

Results: Our main result was that BDNF Val66Met moderated the relationship between baseline CR and change in executive function performance, in that CR-related differences in function decreased across the …

Sleep Disturbances Among Older Adults In The United States, 2002–2012: Nationwide Inpatient Rates, Predictors, And Outcomes, Alyssa A. Gamaldo, May A. Beydoun, Hind A. Beydoun, Hailun Liang, Rachel E. Salas, Alan B. Zonderman, Charlene E. Gamaldo, Shaker M. Eid

Aging Studies Faculty Publications

Objective/Background: We examined the rates, predictors, and outcomes [mortality risk (MR), length of stay (LOS), and total charges (TC)] of sleep disturbances in older hospitalized patients.

Patients/Methods: Using the U.S. Nationwide Inpatient Sample database (2002–2012), older patients (≥60 years) were selected and rates of insomnia, obstructive sleep apnea (OSA) and other sleep disturbances (OSD) were estimated using ICD-9CM. TC, adjusted for inflation, was of primary interest, while MR and LOS were secondary outcomes. Multivariable regression analyses were conducted.

Results: Of 35,258,031 older adults, 263,865 (0.75%) had insomnia, 750,851 (2.13%) OSA and 21,814 (0.06%) OSD. Insomnia rates increased significantly (0.27% in …

Characteristics And Predictors Of Fatigue Among Men Receiving Androgen Deprivation Therapy For Prostate Cancer: A Controlled Comparison, Ashley M. Nelson, Brian D. Gonzalez, Heather S.L. Jim, Julie M. Cessna, Steven K. Sutton, Brent J. Small, Mayer N. Fishman, Babu Zachariah, Paul B. Jacobsen

Aging Studies Faculty Publications

Purpose: Although fatigue is a common problem for men with prostate cancer undergoing androgen deprivation therapy (ADT), there has been little systematic research on this issue. The present study examined changes in fatigue among prostate cancer patients receiving ADT compared to controls and predictors of heightened fatigue in ADT patients.

Methods: Prostate cancer patients treated with ADT (ADT+ group, n = 60) completed assessments of fatigue prior to or just after ADT initiation (baseline) and 6 and 12 months later. Prostate cancer patients treated with prostatectomy only (ADT- group, n = 85) and men without cancer (CA- group, n = …

Medicare Claims Indicators Of Healthcare Utilization Differences After Hospitalization For Ischemic Stroke: Race, Gender, And Caregiving Effects, David L. Roth, Orla C. Sheehan, Jin Huang, James D. Rhodes, Suzanne Judd, Meredith Kilgore, Brett Kissela, Janeet P. Bettger, William E. Haley

Aging Studies Faculty Publications

Background—Differences in healthcare utilization after stroke may partly explain race or gender differences in stroke outcomes and identify factors that might reduce post-acute stroke care costs.

Aim—To examine systematic differences in Medicare claims for healthcare utilization after hospitalization for ischemic stroke in a United States (US) population-based sample.

Methods—Claims were examined over a 6-month period after hospitalization for 279 ischemic stroke survivors 65 years or older from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. Statistical analyses examined differences in post-acute healthcare utilization, adjusted for pre-stroke utilization, as a function of race (African American …

Changes In Physical Functioning And Muscle Strength In Men Receiving Androgen Deprivation Therapy For Prostate Cancer: A Controlled Comparison, Brian D. Gonzalex, Heather S. L. Jim, Brent J. Small, Mayer N. Fishman, Babu Zachariah, Randy V. Heysek, Paul B. Jacobsen

Aging Studies Faculty Publications

Purpose: The purpose of the study is to examine changes in muscle strength and self-reported physical functioning in men receiving androgen deprivation therapy (ADT) for prostate cancer compared to matched controls.

Methods: Prostate cancer patients scheduled to begin ADT (n = 62) were assessed within 20 days of starting ADT and 6 and 12 months later. Age and geographically matched prostate cancer controls treated with prostatectomy only (n = 86) were assessed at similar time intervals. Grip strength measured upper body strength, the Chair Rise Test measured lower body strength, and the SF-12 Physical Functioning scale measured self-reported physical functioning. …

Apolipoprotein E And Clusterin Can Magnify Effects Of Personality Vulnerability On Declarative Memory Performance In Non‐Demented Older Adults, Sharaddha Sapkota, Sandra A. Wiebe, Brent J. Small, Roger A. Dixon

Aging Studies Faculty Publications

Objectives: Recent research has linked psychological (personality) factors and specific genetic risk polymorphisms to performance on neurocognitive phenotypes. We examined whether episodic or semantic memory performance is associated with (a) three personality traits (i.e. neuroticism, extraversion, and openness to experience), (b) two neurodegenerative‐related polymorphisms (i.e. Apolipoprotein E (APOE; rs7412; rs429358), Clusterin (CLU; rs11136000)), and (c) cross‐domain risk interactions (magnification effects).

Methods: Linear growth models were examined to test independent associations between personality traits and declarative memory performance, and potential interaction effects with APOE and CLU genetic risk. Normal older adults (n = 282) with personality …

Training For Research And Teaching In Geropsychology: Preparing The Next Generation Of Scholars And Educators, Brian D. Carpenter, Erin Sakai, Michele J. Karel, Victor A. Molinari

Aging Studies Faculty Publications

For geropsychology to flourish in the years ahead, we need scientists to advance knowledge and teachers to draw new professionals into the field. In this project the authors surveyed 100 geropsychologists who completed a doctoral degree in clinical or counseling psychology about their experience with training for research and teaching. The majority were currently conducting some degree of research (38%) and some form of teaching (45%). The majority of ratings for components of research training were in the “very good to excellent” range, whereas elements of teacher training were rated in the “poor to good” range, though there was variability …

Incremental Validity Of Useful Field Of View Subtests For The Prediction Of Instrumental Activities Of Daily Living, Frederik Aust, Jerri D. Edwards

Aging Studies Faculty Publications

Introduction: The Useful Field of View Test (UFOV®) is a cognitive measure that predicts older adults’ ability to perform a range of everyday activities. However, little is known about the individual contribution of each subtest to these predictions, and the underlying constructs of UFOV performance remain a topic of debate.

Method: We investigated the incremental validity of UFOV subtests for the prediction of Instrumental Activities of Daily Living (IADL) performance in two independent datasets, the SKILL (n = 828) and ACTIVE (n = 2426) studies. We then explored the cognitive and visual abilities assessed by UFOV …

Predicting Mortality In Patients Treated Differently: Updating And External Validation Of A Prediction Model For Nursing Home Residents With Dementia And Lower Respiratory Infections, Simone P. Rauh, Martijn W. Heymans, David R. Mehr, Robin L. Kruse, Patricia Lane, Neil W. Kowell, Ladislav Volicer, Jenny T. Van Der Steen

Aging Studies Faculty Publications

Objective To evaluate whether a model that was previously developed to predict 14-day mortality for nursing home residents with dementia and lower respiratory tract infection who received antibiotics could be applied to residents who were not treated with antibiotics. Specifically, in this same data set, to update the model using recalibration methods; and subsequently examine the historical, geographical, methodological and spectrum transportability through external validation of the updated model.

Design 1 cohort study was used to develop the prediction model, and 4 cohort studies from 2 countries were used for the external validation of the model.

Setting Nursing homes in …